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882 (2) a/✓,e LOT NO.
7BF� 1 .
l �BAN FOR PLUMBING PERMIT
T (CITY OF CUPERTINO
DITYAN �UFNTIN� 195_ Permit No.
Fee $
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
4 Cupertino, and all other laws appli ble thereto.
a
u Use of Premises
:a
v
`" Owner
� ddress
IN 'Address
a 89oC ' .�AQ%DWENT A
Phone JfiAu*A [t. LIFORNIA _ pPIOVe
• PLOMBING INSPECTOR
CIXEURES NUMBER MAIN DRAIN
UNITS FEES IUNITS I FEES
Water Nater Size f!�/
Water Closets Material
Bath Tubs To Curb
Showers' II To Prop. Line
Lavatories o Existing
Kitchen Sinks Not oov
Dish Washers SEWER © CES
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink,&Traysj To Curb
Dental Units IIlr' -
Drinking Fountains) 1 II
Floor Drains II WATER SYSTEM
Hoppers IL Size
Restaurant Sinks 11 Material
Sand Traps 11 TOTA EES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee I
Sprinkler Valves II Water Sys. Fee I/
Permit Fee
TOTAL 9 :�l TOTAL
RECORD OF INS_P4CTION
Partial Rough 1—
Rough Complete
Fi j'
Cupertino Sanitary
Offke Copy
' BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO //aa
❑ Sewer Connection Sanitary Permit No. .../. �!" 4 .......
(� Plumbing Final Plumbing Permit No. .....z!...(!---- .......-
_---�
d Lot No.. ...../..'J�.-7:.
Owner or Tenant . �.t/7? .....
At ... ------
Tract ----.... ... pp��.f..�Q----.....:._...._._._..---...--------..../......
Date Connected -----------------------------X.. - ..__........: -- ...._.. -- .- 19...
Date Final --------------------------{ �J 19.
._.... :--.........----......-.--_---------------------`--
........................... ............
-.
111 1/60-500 !//PLUMBING INSPECTOR